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10 Cards in this Set
- Front
- Back
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Systolic Dysfunction in CHF
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Decreased ejection fraction
Causes: 1) Recent MI 2) Cardiomyopathy 3) Myocarditis |
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Diastolic Dysfunction in CHF
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Impaired ventricular filling in diastole (impaired relaxation of Left ventricle
Causes: 1) HTN --> myocardial hypertrophy 2) Valvular diseases (aortic stenosis, mitral stenosis, aortic regurg) 3) Restrictive cardiomyopathy |
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Symptoms of Left-Sided Heart Failure
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1) Dyspnea - 2/2 pulmonary congestion
2) Orthopnea 3) Paroxysmal Nocturnal Dyspnea (PND) 4) NOCTURNAL COUGH 5) CONFUSION & MEMORY IMPAIRMENT - 2/2 inadequate brain perfusion 6) Diaphoresis and cool extremities at rest |
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Signs of Left-Sided Heart Failure
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1) Displaced PMI - 2/2 cardiomegaly
2) Pathologic S3 3) Pathologic S4 4) Crackles/rales at lung bases 5) Dullness to percussion and decreased tactile fremitus of lower lung fields - 2/2 pleural effusion 6) Increased intensity of pulmonic component of S2 - 2/2 pulmonary HTN |
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New York Heart Association (NYHA) Classification of CHF
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NYHA Class I: Symptoms only with vigorous activity
NYHA Class II: Symptoms with prolonged or moderate exertion NYHA Class III: Symptoms with activities of daily living (getting dressed) NYHA Class IV: Symptoms at rest |
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Symptoms/Signs of Right-Sided Heart Failure
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1) Peripheral pitting edema
2) Nocturia - 2/2 increased venous return with leg elevation 3) Jugular venous distention 4) Hepatomegaly/hepatojugular reflex 5) Ascities 6) Right ventricular heave |
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Diagnosis of CHF
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1) CXR
2) Echocardiogram (systolic vs. diastolic dysfunction) 3) Radionuclide ventriculography w/ technetium-99m 4) Cardiac catheterization (CAD as cause?) 5) Stress testing |
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Treatment of CHF
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1) Sodium restriction: <4g/day
2) Diuretics 3) ACE Inhibitors (and ARBs) 4) Beta-blockers 5) Digitalis 6) Hydralazine and isosorbide dinitrates *ACEIs REDUCE MORTALITY, prolong survival, and alleviate symptoms *B-Blockers DECREASE MORTALITY in patients POST-MI heart failure |
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Which classes of heart failure show reduced morbidity and mortality with Spironolactone?
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Class III and Class IV
*Contraindicated in renal failure |
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B-type Natriuretic Peptide (BNP)
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Released from ventricles in response to increased volume and pressure overload
*Levels >100pg/ml = decompensated CHF |
